Jing Nan, Hou Yi-Chen, Zhang Jia-Chang, Xu Guangyu, Lei Mingcheng, Tang Xiaobin, Chen Wei, Ni Hongbin, Zhang Feng
Department of Rehabilitation Medicine, CNPC Central Hospital, Langfang, 065000, PR China.
Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, PR China.
J Orthop Translat. 2025 Jan 21;50:403-412. doi: 10.1016/j.jot.2024.11.006. eCollection 2025 Jan.
Bone non-union has always been a research hotspot in the field of orthopedics. Non-unions are often accompanied by symptoms such as pain, deformity, and dysfunction, which can significantly affect patients' quality of life and cause related socioeconomic problems. Clinically, there are various treatments available for non-unions, and the main treatment methods are divided into surgical and non-surgical treatments. At present, surgery is the most widely used treatment for bone non-unions and has a high healing rate. However, even after surgery, some patients still face the problem of bone non-union. Furthermore, a small number of patients have surgical contraindications and could not tolerate surgery. Therefore, alternative treatments are needed to improve outcomes for patients with bone fractures. Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment method with similar efficacy and better safety compared with surgery. Nevertheless, the exact mechanism for ESWT to treat patients with bone non-union are still not well understood. This article reviews the mechanisms of ESWT in promoting bone fracture healing by regulating osteoblasts and osteoclasts, providing a theoretical foundation for the clinical application of ESWT. The Translational Potential of this Article: This review provides a comprehensive overview of the mechanisms underlying ESWT on promoting bone fracture healing by regulating osteoblasts and osteoclasts. The information provided in this article can offer a novel non-invasive method for clinicians to treat bone non-union.
骨不连一直是骨科领域的研究热点。骨不连常伴有疼痛、畸形和功能障碍等症状，会显著影响患者的生活质量，并引发相关的社会经济问题。临床上，骨不连有多种治疗方法，主要治疗手段分为手术治疗和非手术治疗。目前，手术是治疗骨不连应用最广泛的方法，愈合率较高。然而，即使经过手术，一些患者仍面临骨不连问题。此外，少数患者存在手术禁忌证，无法耐受手术。因此，需要其他治疗方法来改善骨折患者的治疗效果。体外冲击波疗法（ESWT）是一种非侵入性治疗方法，与手术相比，疗效相似且安全性更好。然而，ESWT治疗骨不连患者的确切机制仍未完全明确。本文综述了ESWT通过调节成骨细胞和破骨细胞促进骨折愈合的机制，为ESWT的临床应用提供理论基础。本文的转化潜力：本综述全面概述了ESWT通过调节成骨细胞和破骨细胞促进骨折愈合的潜在机制。本文提供的信息可为临床医生治疗骨不连提供一种新的非侵入性方法。
